Program Summary Report: Centers for Medicare & Medicaid ... · Fostering the dissemination of...

Program Summary Report: Centers for Medicare & Medicaid Services Minority Research Grant Program

December 2019

CMS Minority Research Grant Program

PROGRAM SUMMARY REPORT | II

Table of Contents

Introduction ......................................................................................................................... 1

MRPG Activity: Fiscal Year 2019 ........................................................................................ 2

Grantee Characteristics and Outcomes 2005-2019 ............................................................. 2

Target Populations and Reach................................................................................... 3

Target Condition and Key Outcomes ......................................................................... 4

Dissemination of Minority Research Grant Findings ................................................... 5

Summary ............................................................................................................................ 5

References ......................................................................................................................... 7

Appendix A. Summary of Minority Research Grant Program, 2005-2019 ........................... 8

List of Exhibits:

Exhibit 1 Overview of Current and Recent Grantees ............................................................. 2

Exhibit 2 Geographic Distribution of Funded Institutions Awarded 2005-2019 ...................... 4

Exhibit 3 Minority Research Grant Program Research Dissemination 2005-2019.................. 5


PROGRAM SUMMARY REPORT | 1

Introduction

The Minority Research Grant Program (MRGP) is a part of the Centers for Medicare & Medicaid

Services (CMS) efforts to identify and disseminate promising practices for reducing health disparities

among minority beneficiaries. It supports CMS in its mission of achieving health equity for all CMS

beneficiaries, by:

► Supporting researchers to pursue topics that impact minority beneficiaries;

► Investigating the root causes of health disparities to achieve a better understanding of how to

reduce disparities; and

► Fostering the dissemination of grantee research within CMS policies and programs, and

beyond to improve health quality.

The Program was founded in response to two Executive Orders that currently stand as:

Executive Order 13779: White House Initiative to Promote Excellence and Innovation at Historically

Black Colleges and Universities,

Executive Order 13555: White House Initiative on Educational Excellence for Hispanics.

The Program historically consisted of two grants:

► Historically Black Colleges and Universities (HBCU) Research Grant, which provided

funding for researchers from HBCUs to implement research activities that meet the needs of

African American CMS beneficiaries; and the

► Hispanic Health Services Research Grant, which provided funding for researchers from

Hispanic Serving Institutions (HSIs) to implement research activities that meet the needs of

Hispanic CMS beneficiaries.

In 2018, the Program combined the two previously available funding opportunities for Hispanic health

researchers and HBCUs under one grant program and expanded eligibility to include Asian-American Native

American Pacific Islander Serving Institutions (AANAPISIs) and Tribal Colleges and Universities (TCUs).

These changes were made to improve alignment with CMS OMH’s overall mission and vision, streamline

the application and review process, broaden the number of minority populations served by this Program, and

increase responsiveness to the following Executive Orders, which call on agencies within the executive

branch to bolster their support for minority serving institutions:

Executive Order 13592: Improving American Indian and Alaska Native Educational Opportunities

and Strengthening Tribal Colleges and Universities

Executive Order 13515: Increasing Participation of Asian Americans and Pacific Islanders in Federal

Programs

This report builds upon an earlier report summarizing grantee characteristics and performance from 1996-

2005 by focusing on 46 grants made from 2005-2019.1 It provides an overview of active grantees, as of



fiscal year 2019, and a summary of characteristics and findings of previous grantees from the 2005-2019

fiscal years. This includes information about how previous grantees disseminated the results of their

studies through publications and presentations in the U.S. Further details on grantees’ areas of focus,

organization, type of institution, project name, funding period and award amount can be found in

Appendix A, when available. By aggregating information about grantees and documenting their

achievements, this report serves as a reference point for future efforts.

MRPG Activity: Fiscal Year 2019

As of October 2019, CMS is managing seven grantees; this includes those awarded in 2018, and 2019 as

well as two with no-cost extensions (NCEs). Exhibit 1 provides an overview of the topics covered by

these grantees. Appendix A provides an overview of all current and past grantees.

Exhibit 1 Overview of Current Grantees

Award Year Grantees

Principal Investigators

Research Topic

Current Grantees

2019

University of Houston Taewoo Lee, Ph.D. Increasing resources for minority patients with diabetic eye disease

University of Miami

Roderick King, M.D., M.P.H. (Co-PI)

Joseph West, Sc.D. (Co-PI)

Using community health workers to improve access to health services among vulnerable populations

2018

University of Houston Sharon Borja, Ph.D., M.S.W.

Developing an electronic fotonovela intervention in Spanish to support post-hospitalization symptom management, improve patient engagement, and strengthen patients’ natural supports

University of Puerto Rico Medical Sciences Campus

Carmen Zorrilla, M.D. Reducing prenatal stress for women in Puerto Rico post Hurricane Maria through group prenatal care

Grantee with No-Cost Extensions

2017

Charles R. Drew University of Medicine & Science

Mohsen Bazargan, Ph.D.

Reducing medication-related challenges among older adults with hypertension

Winston-Salem State University

Cynthia Williams, Ph.D.

Preventing obesity through lifestyle change

Grantee Characteristics and Outcomes 2005-2019

This summary includes information from the 46 grantees funded between 2005 and 2019. Information

related to the findings and dissemination of these grantees is specific to the 36 grantees who closed out

and submitted final reports as of fiscal year 2019.



Target Populations and Reach

The MRGP has funded a range of projects focusing on various

populations that experience health disparities. HBCU and HSI grantees

have focused on health disparities affecting African Americans and

Hispanics, respectively. Investigators supported by this funding have

focused on various sub-populations within these groups, such as low

income, older adults, and pregnant women. Some grantees focused on

issues that predominantly affect men, such as colon cancer, while others

focused on issues that predominantly affect women, such as breast

cancer.

The average sample size of each study was approximately 345. Some studies compared multiple

intervention groups, and some utilized intervention and control groups that were actively recruited from

communities. With an average of three projects funded per year since 2005, the total number of minority

individuals that participated in the MRGP studies totals over 13,000. This number underscores the

potential that the Program has to sponsor research that effectively engages populations experiencing

health disparities.

13,500+ African

American and Hispanic

study participants since

2005.

Padres activos y terapistas entregados: Increasing activation and engagement in parent-provider

interactions

The University of North Carolina, 9/30/2016-9/29/2018.

This project implemented an adaptation of the MePrEPA (Metas, Preguntar, Eschuchar, Preguntar

para Aclarar or goals, questioning, listening, questioning to clarify) curriculum to demonstrate that the

positive effects of Latino parents bringing children to Spanish-language mental health clinics are

reproducible in other ethnically diverse mental health settings. Investigators utilized electronic health

records data and linked it with primary study data which was a promising way to assess impact of the

intervention on health care service use. The psychoeducational intervention was effective at

improving patient activation among Latino mothers raising a child with mental health or

developmental and found:

► Participants in the intervention group were more likely to appropriately access health services.

► Participants in the intervention group experienced a modest positive increase in the self-

reported outcomes measuring parent and education activation.

► PROMIS pediatric parent proxy scores for anger and depression decreased in participants in

the intervention group compared to the control group.

Dissemination activities for this project included three presentations within the local community and

at regional conferences; and one forthcoming manuscript to be submitted in Psychiatric Services.

Grantee Spotlight



Sixteen grantees have been from the South and Southeast regions of the United States, where chronic

diseases such as obesity and diabetes are most prevalent.23 To illustrate this, Exhibit 2 below shows the

geographic distribution of funded grantees within the United States and also shows the density of funded

institutions within these regions.

Exhibit 2 Geographic Distribution of Funded Institutions Awarded 2005-2019

Target Condition and Key Outcomes

Grantees funded during 2005-2019 addressed a variety of health issues, including chronic diseases such

as asthma, heart disease/hypertension and obesity. Grantees also developed and/or evaluated projects

seeking to address breast, prostate, and colorectal cancer. In addition to

disease-specific research projects, grantees also investigated health care

access, medication adherence/management, maternal & child health, patient

experience, and reducing hospitalizations. The most common health issue

investigated by grantees was diabetes, with ten grantees focusing on this

health issue during 2005-2019. Overall, the grantees reported positive

outcomes in their final reports in a variety of domains, including

improvements in:

Diabetes is the

most common health

issue studied by

grantees 2005-2019.



► Health-related knowledge among minority populations, particularly related to breast cancer,

colorectal cancer, diabetes, hypertension, prostate cancer, proper medication use, and prostate

cancer.

► Health-related attitudes and self-efficacy in the interventions they developed.

► Health behaviors such as prostate cancer screening, the purchase of healthier foods,

breastfeeding rates, and preventive care utilization.

► Health outcomes such as decreased weight gain, improved blood sugar and blood pressure

control, increased access to care, and reduced health care costs.

Dissemination of Minority Research Grant Findings

Many of the grantees reported disseminating their findings academically through peer reviewed journals

and conferences, as well as to the communities that they served or that participated in their research.

Exhibit 3 below illustrates the extent to which the 36 grantees that submitted final reports for 2005-2019

were successful in disseminating their results.

Exhibit 3 Minority Research Grant Program Research Dissemination 2005-2019

Summary

In accordance with CMS’s vision of achieving health equity for all CMS beneficiaries, the MRGP

supports the development of health services researchers who are able to successfully engage minority

populations and conduct research that supports the elimination of health disparities for them. Through

their work, these researchers have the potential to increase understanding and awareness of disparities,

develop and disseminate solutions for reducing disparities, and accelerate implementation of effective

actions.



Supporting these organizations aligns with the White House Initiatives. HBCUs and HSIs play a key role

in providing high-quality education, job training and social support to under-represented and underserved

populations, particularly African American and Hispanic individuals.4 HBCUs provide an environment in

which minority students can empower one another, particularly through modeling academic and career

success. 5 Because of their strong relationships with local communities, HBCUs are able to conduct health

disparities research that has the potential to more effectively engage and serve minority populations. By

strengthening the capacity of these institutions and the researchers associated with them, MRGP seeks to

widen the pipeline of researchers interested in disparities with connections to minority communities. Non-

white investigators are more likely than white investigators to propose topics such as health disparities

and to use study designs that includes humans, communities, and behavioral interventions.6

This report provides an overview of current activities as of fiscal year 2019 and a summary of

characteristics and findings of previous grantees from the 2005-2019 fiscal years. During this period, a

total of 46 grants were awarded. The grantees focused on a diverse range of health topics affecting

African American and Hispanic individuals. Many grantees developed, implemented and evaluated the

effectiveness of interventions geared toward improving disease-specific outcomes, as well as health care

access and appropriate care utilization. Across this broad range of interventions, grantees reported

improvements in health related knowledge, attitudes and behaviors. Grantees disseminated this work

through community-oriented presentations and outreach as well as through peer-reviewed publications

and academic presentations. By documenting the achievement of grantees, this report illustrates how

MRGP can be an important mechanism for supporting health disparities research. It may also serve as a

reference point for future efforts.

An Intervention to Improve Blood Pressure Control among African American Older Adults,

Charles R. Drew University of Medicine and Science, 9/30/2014-09/29/17

The purpose of this project was to document prevalence and correlates of (i) non-adherence to

medications, (ii) polypharmacy, and (iii) inappropriate medication use among older hypertensive

African American adults living in South Los Angeles County. This included assessing their use of

potentially inappropriate medications (PIMs), or drug-drug interactions that should be avoided in the

elderly. The study found that slightly less than half of participants were taking PIMS and only one

third of all participants disclosed appropriate medication adherence in the last two weeks prior to the

study interviews. Investigators identified strong associations between polypharmacy and PIMs, co-

morbidities, and having multiple providers.

In 2017, Dr. Mohsen Bazargan reapplied and received a new MRGP grant. His current study is

focused on reducing medication-related challenges among diabetic and hypertensive older Latino

adults. Dr. Bazargan’s work has resulted in three national conference presentations as well as various

local presentations, and 15 peer-reviewed publications. This team continues to prepare additional

manuscripts.

Grantee Spotlight



References

1. Randolph S. Program Assessment for the HBCU/Hispanic Health Services Research Grant

Program.; 2006. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-

and-Reports/Reports/Downloads/Randolph.pdf.

2. Wang Y, Beydoun MA. The Obesity Epidemic in the United States—Gender, Age,

Socioeconomic, Racial/Ethnic, and Geographic Characteristics: A Systematic Review and Meta-

Regression Analysis. Epidemiol Rev. 2007;29(1):6-28. http://dx.doi.org/10.1093/epirev/mxm007.

3. Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2017. Atlanta,

GA; 2017. https://www.cdc.gov/diabetes/data/statistics/statistics-report.html.

4. Penn GSE CMSI. A Brief History of MSI". https://cmsi.gse.upenn.edu/content/brief-history-msi.

5. Gallo R, Davis R. The Impact of Town–Gown Relationships on the Sustainability of African

American Communities: An Examination of the Role of HBCUs. J African Am Stud.

2009;13(4):509-523. http://www.jstor.org/stable/41819229.

6. Carnethon MR, Kershaw KN, Kandula NR. Disparities Research, Disparities Researchers, and

Health Equity. JAMA. 2020;323(3):211–212. doi:10.1001/jama.2019.19329



Appendix A. Summary of Minority Research Grant Program, 2005-2018

Disease Focus Organization Type of Institution

Grant Number Project Name Start Date

End Date

Federal Budget

Asthma Texas Southern University

HBCU 1I0CMS331440 Uncontrolled Asthma Among Pediatric African Americans

9/30/2015 9/30/2017 $215,000.00

Breast Cancer

American University HSI 1H0CMS331362 The Role of a m-Health Technology in Breast Cancer Prevention among Hispanic Women

9/30/2014 9/29/2017 $200,000.00

Charles R Drew University of Medicines& Science

HSI 1H0CMS300041

An educational intervention program to increase mammography screening among Hispanic women in low income public housing; Lay title: The South Los Angeles Breast Health Promotion Project.

9/30/2005 3/29/2008 $125,000.00

Fayetteville State University

HBCU 1I0CMS300100

The Fayetteville Area Inter-Faith Commitment to Colorectal Health Awareness and Cancer Reduction in African Americans (The F.A.I.T.H Project)

9/30/2006 9/29/2009 $119,598.76

Health Care Access

University of Miami HSI 1W1CMS331752

Healthy Adaptive Behavior and Intervention on Trauma – Response and Care (HABIT-RC): Epidemiologic Survey of African-American and Latino Men in Miami-Dade County (PHASE-I)

9/30/2019 9/29/2021 $250,000.00

Jackson State University

HBCU 1I0CMS331295

The Community Health House and Health Worker Model: A Novel Intervention for Reducing Health Care Costs and Addressing Health Disparities

9/30/2013 9/29/2016 $200,000.00

The Regents of the University of California San Francisco

HSI 1H0CMS300102

The Effectiveness of a Promotora Health Education Model for Improving Latino Health Care Access in California's Central Valley

9/30/2006 9/29/2009 $116,122.43





End Date

Federal Budget

The University of Pittsburgh

HSI 1H0CMS331535

Effectiveness of a Promotores Network in Improving Access to Care and Health Behaviors in Latino Immigrants in an Emerging Latino Community

9/30/2016 9/30/2019 $215,000.00

University of Houston

HSI 1W1CMS331632-01-01

Developing an electronic fotonovela intervention in Spanish to support post-hospitalization symptom management, improve patient engagement, and strengthen patients’ natural supports

9/30/2018 9/30/2020 $250,000.00

University of South Carolina

HSI 1H0CMS330895

Navegantes para la Salud: Improving Healthcare Access and Utilization among Hispanic Women and Children

9/30/2011 9/29/2014 $215,000.00

Diabetes/ Blood Pressure

Bowie State University

HBCU 1I0CMS300099

Promoting Diabetes Self-Management among African Americans: An Educational Intervention in Prince George's County MD

9/30/2006 9/29/2009 $107,226.79

Howard University HBCU 1I0CMS030310

Talking Fotonovelas to improve health knowledge, attitudes, and practices among community dwelling older AA's regarding diabetes and high blood pressure

9/30/2008 9/29/2011 $85,192.61

Meharry Medical College

HBCU 1I0CMS330899 Improving Diabetes Management in African Americans Using Community Health Centers

9/30/2011 9/29/2014 $141,521.00

National Hispanic Council on Aging

HSI 1H0CMS330897

Health and Wellness Interactive Bingo Health Game: Assessing its Effectiveness to Improve Diabetes Management among Hispanic Older Adults and their Families

9/30/2011 3/31/2014 $119,615.00

Nova Southeastern University Inc.

HSI 1H0CMS030309 Diabetes Literacy and Self-Efficacy Screening and Training Project (Project DLASST)

9/30/2008 9/29/2010 $85,530.91





End Date

Federal Budget

Tennessee State University Center of Excellence

HBCU 1I0CMS030210 Addressing Barriers of Self Management Among African Americans with Type 2 Diabetes

9/30/2007 9/29/2010 $125,000.00

Texas Southern University

HBCU 1I0CMS300041

Determination of the Optimum Intensity of a Culturally Competent Community Based Diabetes Management Education for African Americans in Harris and Surrounding Counties

9/30/2005 9/29/2008 $210,824.00

University of Massachusetts Boston

HSI 1HOCMS300101/02

The Impact of Culturally Oriented Low Literacy Education in Diabetes Related Knowledge and Self Care Behavior in Hispanics with Diabetes

9/30/2006 9/29/2009 $240,940.40

University of Houston

HSI 1W1CMS331751 Optimal Resource Allocation for Diabetic Eye Disease (DED) Screening for Minority Patients

9/30/2019 9/29/2021 $250,000.00


HBCU 1I0CMS331439 The Hosea Project: Training, Equipping and Empowering Churches to Prevent Diabetes

9/30/2015 9/29/2017 $215,000.00

Heart Disease/Hypertension


HBCU 1I0CMS331364

An Intervention to Improve Blood Pressure Control Among Hypertensive African American Seniors in South Los Angeles

9/30/2014 9/29/2017 $200,000.00


HBCU 1I0CMS330900 Sisters Together Empowered for Prevention and Success (STEPS)

9/30/2011 9/29/2014 $109,326.00

HIV/AIDS

California State University Long Beach Foundation

HSI 1H0CMS030209 Protect your family: get tested. Protégé tu familia: hazte la prueba

9/30/2007 9/29/2010 $92,475.51

University of Miami HSI 1H0CMS330896 Increasing Medication Adherence among HIV+ Hispanics: A Culturally Tailored Application of the IMB

9/30/2011 9/29/2014 $112,042.65





End Date

Federal Budget

University of Miami HSI 1H0CMS331441

A Project to Adopt, Implement and Evaluate an Intervention to Increase the Uptake of Immunizations in HIV Infected People

9/30/2015 9/29/2017 $112,042.65

Virginia State University

HBCU 1I0CMS330898 Promoting HIV/AIDS Prevention Among Older African American Adults

9/30/2011 9/29/2014 $153,572.00

HPV Dillard University HBCU 1I0CMS331297

Impact of a Human Papilloma Virus Educational Intervention Study (EIS) on the Knowledge, Health Beliefs, Health Behaviors, and Increasing the Use of Gardasil Vaccine in Women of Color

9/30/2013 9/29/2017 $200,000.00

Maternal & Child Health

Arizona State University

HSI 1H0CMS030207

Famililas Sanas (Health Families): A culturally grounded approach to improve the interconception care of Latino mothers.

9/30/2007 9/29/2009 $124,239.83

Shaw University HBCU 1I0CMS300040

The Shaw-Duke Maternal and Infant Mortality Initiative: Interventions to Improve the Outcomes among Pregnant Medicaid Recipients

9/30/2005 7/29/2008 $125,000.00

The University Corporation (California State University Northridge)

HSI 1H0CMS330803 Telephone-Based Support and Education to Promote Breastfeeding Rates in Latina Medicaid Recipients

9/30/2010 9/29/2012 $99,845.39

University of Puerto Rico Medical Sciences Campus

HSI 1W1CMS331633-01-02

Reducing prenatal stress for women in Puerto Rico post Hurricane Maria through group prenatal care

9/30/2018 9/29/2018 $250,000.00

Medication Adherence Charles R Drew University of Medicines& Science

HBCU 1I0CMS030458

Multi-disciplinary investigational intervention on reducing polypharmacy and enhancing adherence to drug regimes among AA elderly persons.

9/30/2009 9/29/2012 $140,724.00





End Date

Federal Budget


HSI 1H0CMS331621 Reducing medication-related challenges among older adults with hypertension

9/30/2017 9/29/2019 $325,000.00

Texas Southern University

HBCU 1I0CMS330801 Managing Medication Adherence in Elderly Hypertensive Patients through Pharmacists Home Visits

9/30/2010 9/29/2013 $99,690.48

Mental Health

The University of Texas at Arlington

HSI 1H0CMS331363 DESEO: DEpression Screening and Education: Options to Reduce Barriers to Treatment

9/30/2014 9/29/2017 $200,000.00

University of North Carolina at Chapel Hill

HSI 1H0CMS331536

Padres activos y terapistas entregados: Increasing activation and engagement in parent-provider interactions

9/30/2016 9/31/2019 $215,000.00

Obesity


HBCU 1I0CMS331079

Obesity Prevention: An Education Intervention to Control Rapid Weight Gain Among African American Infants and Toddlers

9/30/2012 9/29/2015 $199,937.00

University of Massachusetts Boston

HSI 1H0CMS331089 Improving Food Purchasing Selection among Spanish-Speaking Hispanic Families

9/30/2012 9/29/2015 $199,845.34

University of Texas Health Center at San Antonio

HSI 1H0CMS030457 Nutrition and Exercise Start Today (NEST)

9/30/2009 9/29/2012 $123,519.46


HSI 1I0CMS331622 Preventing obesity through lifestyle change

9/30/2017 9/29/2019 $325,00.00


HBCU 1I0CMS331296 The COACH Approach to Obesity Prevention: Changing Outcomes, Attitudes, Character and Health

9/30/2013 9/29/2016 $200,000.00





End Date

Federal Budget

Prostate Cancer

Clark Atlanta University

HBCU 1I0CMS331537

Educational Interventions for Prostate Cancer Awareness among African-American Men in the South East Region

9/30/2016 7/31/2019 $215,000.00


HBCU 1I0CMS030208 A Prostate Cancer Screening Program for Low Income African Americans

9/30/2007 9/29/2010 $83,718.00

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